OBJECTIVES: Obesity acts as the gateway disease to all Non-Communicable Diseases (NCDs). As the impact of NCDs continues to increase, projected to exceed 70 % of global mortality, there is an urgent need to improve the management of people living with obesity. People involved with health care policy must address the social and economic challenges that will likely develop as a result of the rise and severity in obesity. Therefore, we aimed to explore in the payors and regulatory community across Europe their needs and challenges to implement obesity in a chronic care framework. STUDY DESIGN: Cross-sectional qualitative study. METHODS: In this cross-sectional qualitative study, payors and regulators from various European countries were invited by purposive sampling between 14th of October 2023, and 15th of March 2024, to participate. Payors and regulators were interviewed, and data were transcribed and analysed using thematic analysis according to Qualitative Analysis Guide of Leuven (QUAGOL). RESULTS: A total of 9 payors and 6 regulators were interviewed coming from 11 different European countries. Four themes (Structure of the healthcare system, political challenges, obesity perceptions, obesity treatment and management) were identified wherein challenges were mentioned for obesity. Payors and regulators emphasized the need for a proactive healthcare model, recognition of obesity as a policy-prioritised NCD, the integration of obesity care pathways and health promotion centres, and the registration of obesity in all care settings. CONCLUSIONS: The payor and regulatory community advocated for a proactive approach to obesity, focusing on preventive interventions to mitigate the costs and health complications associated with NCDs.